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Environmental Information Form <br /> Part B <br /> DATE :— MQ i 98 7 <br /> (To be Completed By Applicant ) <br /> NOTE : In completing this form, use additional sheets if necessary . <br /> Answer all questions to the- best of your ability. If a question <br /> is not applicable to your project, write NA (not applicable ) . <br /> Please do not leave blanks . Incomplete forms cannot be accepted. <br /> PERSON COMPLETING; FORM X PROPERTY OWNER AGENT OF OWNER <br /> i <br /> Name Joy' W. Ila n er <br /> Address Sao/ SoIg <br /> City Sfock r5vn <br /> State/Zip C'f gS.Zos <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : Use Permit, Q Major Subdivision, <br /> Q Zone Reclassi-fication, CR Minor Subdivision, Q Site Approval,, <br /> Zone Variance, Q Other : <br /> 2 . Project location: 53 p/ __-5oA= ri Rarch <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify s ecific roject components : Svbdii/id� erisf, ,c)O,^ce/ <br /> /%1fo 3 /o s . 'eel_W usC 71. 6c 0-7 �rc&/ 'A', Two Ya�a� f /o.�s erc�fecl <br /> -{a reslden hQ/ y re <br /> 3 . Total acreage of project: 4. 6 2 $ of existing parcels : <br /> Assessor Parcel Us ) :: C8.2 – /82 - os <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : �/f; <br /> 5 . Other permits and approvals (County, Regiona14 State and Federal ) <br /> required for this project : <br /> PERMIT . . AGENCY <br /> cQ fi 0h _5' Lo . <br /> Minor Subdivision - 7 - ( 6/86 ) <br />